Organization
BEAR CREEK DRUG INC
Active
Other names
BRAMBLETON DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY LOCKHART (PRESIDENT)
(540) 774-8309
Entity
Organization
Contact information
Practice address
3328 BRAMBLETON AVE, ROANOKE, VA 24018-6523
(540) 774-8309
(540) 776-9186
Mailing address
4711 HICKORY HILL DR, ROANOKE, VA 24018-7431
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201000062
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4804111
OTHER ID NUMBER
—
Enumeration date
08/31/2006
Last updated
10/04/2007
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